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［目的］探讨子宫恶性苗勒氏管混合瘤（ＭＭＴ）的诊断与治疗，寻求改善预后的方法。［方法］回顾性分析１９６３年１０月至１９９７年１０月收治的２１例子宫ＭＭＴ的临床资料。［结果］子宫ＭＭＴ无特异临床表现，术前诊断困难，必须重视术前诊刮、宫颈口结节活检及术中冰冻检查。单纯手术６例，手术加化疗１０例，手术加放疗和化疗３例。总的２年、５年生存率为５７％和 ３０％，Ⅰ和 Ⅱ期 ５年生存率分别为 ４５．４％和 ９％，Ⅲ和 Ⅳ期病人均于 ２年内死亡。子宫小于 ３个月妊娠， ５年生存率为４６％，大于３个月妊娠为２５．５％，绝经前与绝经后的５年生存率分别为３３％和２１．４％。［结论］预后与临床期别、病理类型、子宫大小、绝经情况和治疗方法等相关。治疗以手术为主，术后辅以化疗可减少和延缓肿瘤复发和转移。化疗和放疗对治疗局部复发和远处转移有一定疗效。
[Objective] To investigate the diagnosis and treatment of malignant Miele’s mixed tumor (MMT) in uterus, and to find a way to improve the prognosis. [Methods] The clinical data of 21 cases of uterine MMT admitted from October 1963 to October 1997 were retrospectively analyzed. [Results] Uterine MMT has no specific clinical manifestations and difficult to diagnose before operation. It is necessary to pay attention to preoperative curettage, cervical nodule biopsy and intraoperative frozen examination. Simple surgery in 6 cases, surgery plus chemotherapy in 10 cases, surgery plus radiotherapy and chemotherapy in 3 cases. The overall 2-year, 5-year survival rates were 57% and 30%, and the 5-year survival rates for stage I and II were 45.4% and 9%, respectively. Patients in stage III and IV died within 2 years. The uterus is less than 3 months pregnant, the 5-year survival rate is 46%, more than 3 months of pregnancy was 25.5%, pre-menopausal and postmenopausal 5-year survival rates were 33% and 21.4%. [Conclusion] The prognosis is related to clinical stage, pathological type, uterine size, menopause and treatment. Surgical treatment based, postoperative adjuvant chemotherapy can reduce and delay tumor recurrence and metastasis. Chemotherapy and radiotherapy for the treatment of local recurrence and distant metastasis have a certain effect.